Hep B, HIV and prep

Hi everyone, I hope you are all well.

I’m chronic hep b carrier and I was diagnosed less than an year ago. One of the most hurt breaking aspect of my new life after the diagnosis, is that I struggle a lot in my dating life. The shame, the fear of disclosure, all that we all have felt for sure, has limited my dating life. That being said, a month ago I met a girl with whom we have very good chemistry and I think something good can come out out of this. There are few complications though.
She’s vaccinated against Hep B, so she’s technically save to have unprotected sex. However, she’s HIV positive and therefore I’m not save to have unprotected sex. I read somewhere that hepb carriers are not allowed to take prep medication for some reason. Can someone explain to me what exactly is the situation with this?
To mention that we didn’t have any kind of sex so far, with or without protection, neither oral or anything else. Obviously, if we use condoms we’re safe to have sex, but what happens with oral. Am I in high danger of getting HIV?


Dear @Javer,

Thanks for your question. The risk of HIV transmission depends on the viral load of your partner. The lower this is the lower the risk of transmission. For HIV, the current literature suggests that “Undetectable = Untransmittable” in general situations (including unprotected sex).

If you are concerned about transmission during oral sex, there are things called dental dams, which will help limit the risk.

Regarding PrEP, there is no reason that someone with HBV cannot take this. It used to be that PrEP was not recommended for treatment of HBV, but this recommendation has since changed in the most recent WHO guidelines (one may use PrEP as HBV treatment if TDF monotherapy is not available).

Hope this helps,


@ThomasTu thank you very much for the quick response. :blush: I don’t know where I read this about prep and hep b carriers, probably somewhere in the net. The thing is that I want to be 100% safe and don’t want to put my already difficult health situation in more troubles. On Tuesday I have a routine check up with my hepatologist and will discuss this with her as well.


Which country are you from

Hepatitis b doesn’t stop you from getting married…you people are the ones who first discriminate urself to them, always tell Ur partner about the vaccine and tell them that you had it from childhood not through sex… period

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We have discussed this already, and I know she has been vaccinated for hep B, but in the same time she’s hiv positive so not safe for me to have unprotected sex. That being said, I’m not giving up on her, I really want to be and stay with her. We’re both in the UK.

PrEP medication is recommended for those at high risk of HIV, but individuals with chronic hepatitis B should be cautious due to potential liver complications. Consulting a healthcare provider before starting PrEP is important.

Although the risk of HIV transmission through oral sex is low, using barrier methods like condoms or dental dams is recommended to reduce risks. Communication with your partner about hepatitis B and sexual health is crucial. Seeking advice from a knowledgeable healthcare provider is also advisable.

Hi @Javer,

Hope the talk with your hepatologist went OK and that you have a bit more clarity with your situation.



Hi @ThomasTu, to be honest the appointment with didn’t go as I expected, I feel little bit underwhelmed. Firstly, I wasn’t seen by the hepatologist who normally deals with my case, but by a liver nurse. No disrespect to her of course, but I had some questions to make that I think the hepatologist was more suitable to answer. When I took the conversation to the prep medications and if I can use them or not, the nurse didn’t even know what prep is. She tried to Google it, but unfortunately at the moment they had some issue with the Internet in the clinic. I explained to her what Prep medication is, and she still was completly oblivious, like she had never heard about this ever. Anyway, after I explained my situation she said “No, you can’t take prep medication in your situation.” I cannot take her seriously though since she obviously doesn’t know what prep is, so I’ll wait for my next appointment which is in 3 months, and hopefully I will see a hepatologist who probably will know better.

So sorry to hear that, @Javer. Hopefully it will be OK when you see the hepatologist soon.